Thrombolysis

AMBULATORY CARE:

What you need to know about thrombolysis:

Thrombolysis is a procedure to dissolve or break up a blood clot. A blood clot can block blood flow to areas of your body and become life-threatening. Thrombolysis can return blood flow and reduce harm to areas such as your brain, heart, or lungs.

How to prepare for your procedure:

Your healthcare provider will tell you how to prepare for your procedure. He may tell you not to eat or drink anything after midnight on the day of your procedure. He will tell you what medicines to take or not take on the day of your procedure. You may be given contrast liquid before or during the procedure to help your healthcare provider see the clot better. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid.

What will happen during the procedure:

Your healthcare provider will inject medicine into your IV that will help dissolve or break up the clot. It is most commonly given into a vein, but it may be given into an artery. If the medicine is given into an artery, a catheter is guided by x-ray so it is near the blood clot.

What will happen after the procedure:

You will be monitored closely for any problems. Do not get out of bed until your healthcare provider says it is okay. You will then be able to go home or be taken to your hospital room.

The catheter may be left in place if the medicine needs to continue to break up the clot. You will need to stay in the hospital if the catheter is left in place. Your healthcare provider will need to do the thrombolysis again to remove the rest of the clot.

You will be told not to move your leg while the catheter is in place. Tell your healthcare provider if lying flat starts to cause back discomfort. If there is no bleeding, he may help you roll onto your side.

You must use a bedpan or a urinal until you are able to get out of bed and go to the bathroom. If you are unable to use a bedpan or urinal, a Foley catheter may be placed in your bladder. This catheter allows urine to drain from your bladder into a collection bag.

You will need to wear pressure stockings or inflatable boots after your procedure. The stockings are tight and put pressure on your legs. The boots have an air pump that tightens and loosens different areas of the boots. Both of these improve blood flow and help prevent clots.

You may need to walk around the same day of your procedure, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your healthcare provider says you can. Ask before you get up the first time. You may need help to stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call button to let someone know you need help.

Medicines:

Anticoagulants are a type of blood thinner medicine that helps prevent clots. Anticoagulants may cause you to bleed or bruise more easily.

Antiplatelets help prevent blood clots. This medicine makes it more likely for you to bleed or bruise.

Risks of thrombolysis:

Thrombolysis increases your risk for bleeding. You may have increased nosebleeds or bleeding from your gums. You may also have bleeding in your stomach or brain. Bleeding can become severe and life-threatening.

Call 911 for any of the following:

You have any of the following signs of a heart attack:

Squeezing, pressure, or pain in your chest

and any of the following:

Discomfort or pain in your back, neck, jaw, stomach, or arm

Shortness of breath

Nausea or vomiting

Lightheadedness or a sudden cold sweat

You have any of the following signs of a stroke:

Numbness or drooping on one side of your face

Weakness in an arm or leg

Confusion or difficulty speaking

Dizziness, a severe headache, or vision loss

Seek care immediately if:

Your arm or leg feels warm, tender, and painful. It may look swollen and red.

Your wound does not stop bleeding even after you apply firm pressure for 10 minutes.

The leg or arm used for your procedure is numb, painful, or changes color.

The bruise at your catheter site gets bigger or becomes swollen.

You have purple spots or blisters on your skin.

Contact your healthcare provider if:

You have a fever.

You have a new skin rash and itching.

You feel weak, lightheaded, or faint.

You have new swelling around your eyes.

You see blood in your urine.

You have questions or concerns about your condition or care.

Follow up with your healthcare provider as directed:

You may need to be checked for blood clots for up to 3 years after treatment. Write down your questions so you remember to ask them during your visits.

Wound care:

Keep your wound clean and dry. Ask your healthcare provider when you can bathe. You will need to keep the bandage in place and dry for a day or two after your procedure. Cover the bandage with a plastic bag and tape the opening around your skin to keep water out. When you are allowed to bathe without a bandage, carefully wash the wound with soap and water. Check the wound daily for signs of infection, such as redness, swelling, or pus. Dry the area and put on new, clean bandages as directed. Change your bandage if it gets wet or dirty.

Watch for bleeding and bruising:

It is normal to have a bruise and soreness where the catheter went in. Contact your healthcare provider if your bruise gets larger. If your wound bleeds, use your hand to put pressure on the bandage. If you do not have a bandage, use a clean cloth to put pressure over and just above the puncture site. Seek care immediately if the bleeding does not stop within 10 minutes.

Wear pressure stockings as directed:

Pressure stockings help keep blood from pooling in your leg veins. Your healthcare provider can prescribe stockings that are right for you. Do not buy over-the-counter pressure stockings unless your healthcare provider says it is okay. They may not fit correctly or may have elastic that cuts off your circulation. Ask your healthcare provider when to start wearing pressure stockings and how long to wear them each day.

Keep your leg elevated as directed:

Keep your leg above the level of your heart when you are sitting. Prop your leg on pillows to keep it elevated comfortably. Ask how long to keep your leg elevated each day. You will need to balance elevation with movement to prevent blood clots.

Prevent another blood clot:

Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause blood vessel and lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.

Limit alcohol. Do not drink alcohol for 24 hours after your procedure. Then limit alcohol. Women should limit alcohol to 1 drink a day. Men should limit alcohol to 2 drinks a day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.

Stay active. Your healthcare provider will tell you when it is safe to drive and start doing your other normal daily activities. Go slowly at first. Then increase your activity. An active lifestyle can help prevent blood clots. Try to get at least 30 minutes of activity on most days of the week. If you sit most of the day for work, stand or walk around every half hour. After a future injury or illness, try to become active again as soon as possible. Activity can also help you manage your weight. Overweight or obesity can put pressure on your leg veins and cause blood to pool. This increases your risk for another blood clot.

Manage other health conditions. Follow your healthcare provider's directions to manage health conditions that can cause a blood clot. Examples are high cholesterol and diabetes.

Drink liquids as directed. Liquid can help prevent blood clots. Ask your healthcare provider how much liquid to drink each day and which liquids are best for you.